I got arrested for possession and was kept in a holding cell for one night. This wasn’t my first offense, but other times I’d been let off with probation or did programs to stay out of jail. This time, they didn’t let it slide. I ended up taking a plea for 45 days.

I was pretty anxious. I’d heard stories of jail, about how there’s no privacy and you get humbled real quick. But I had a valid methadone prescription from a doctor. I would be ok, right?

Wrong. At the jail intake I saw the officer, and then a nurse. She took my vitals and asked some questions about the medications I was on. I listed them. She told me they would have to get delivery of the medications, so I might not get them until the following day. That’s all that was said.

The next day, I had that horrible feeling of being dopesick. I was counting down the seconds to the med call. I didn’t have much else to do, as I’d been alone in that cell for 23 out of the last 24 hours.

The nurse said this was the jail’s “opioid protocol”—ibuprofen and Bentyl, then at night they would add trazodone to help me sleep.

Finally, I heard med call announced and they opened my cell. I went to see the nurse on duty. She had three meds for me: my antidepressant, ibuprofen and something I wasn’t sure what it was. I asked, and she said Bentyl. Much later, I learned it’s a gut antispasmodic, sometimes used to treat irritable bowel syndrome.

I told the nurse I didn’t take that, but that I was missing my prescribed methadone. She replied that this was the jail’s “opioid protocol”—ibuprofen and Bentyl, then at night they would add trazodone to help me sleep.

I thought the stripping down, squatting and coughing while grabbing my cheeks that I had to undergo during intake was humbling enough. But it turned out to have nothing on the reality that I would be in a cell by myself 23 hours a day, while getting checked on every 15 minutes to make sure I didn’t kill myself, presumably because the withdrawal was so bad.

By the next day, I was utterly miserable. I still naively thought that maybe if I could just see the doctor, I could get this fixed. Nope. They didn’t give opioids in this jail, regardless of medical need. So I was going to suffer far beyond what the court had determined as my punishment.

As the days crawled by, I went through hell. I told myself I needed to stop using, because I couldn’t do this ever again.

As soon as I got out, everything I’d said to myself went out the window. I needed to get high. A little while later, I overdosed.

Ironically, the fact that the jail was overcrowded cut the misery short. Because they’d run out of space, they released me early, after two weeks.

As soon as I got out, everything I’d said to myself went out the window. I needed to get high. A little while later, I overdosed—becoming another statistic showing people’s vulnerability after enforced abstinence, lost tolerance and release.

After surviving that, I made a change. I wasn’t going to use heroin anymore, just methadone. I maintained that for seven months. But due to other medical issues I wasn’t working, so I was in dire need of money. And there was only one other way I knew how to get it, which was to sell drugs. Shocker! I got caught and went back to jail.

This time, I lucked out and was offered a diversion program called Accelerated Rehabilitative Disposition. Because of that, I was only in jail for a week. But coming out, I needed a heroin fix faster than I could drive the two miles to pick it up.

I soon got arrested again and was given six months. But I wasn’t as miserable as before, because this time I planned ahead.

On my previous trips to jail, I’d seen how they searched my prosthetic leg, and what they missed. So I took a baggie full of methadone pills, and stuffed it inside the pole connecting the socket to the foot. They didn’t find it.

I was still scared that the corrections officers would see I wasn’t going through withdrawal as bad as before. But the threat of getting more time added for bringing in contraband didn’t stop me. I refused to go through the county-sponsored torture again. Withdrawal in jail feels so much worse then when you’re outside.

Even today, as the overdose crisis continues, you have no chance of getting methadone in most US jails.

All these times I went to jail, I was sometimes able to see a doctor. And I still can’t comprehend how watching so many people being tortured because they didn’t have their methadone could be compatible with doctors’ ethical imperative to “do no harm.”

Methadone is a prescribed medication and a lifesaver. It cuts mortality for people with opioid use disorder by half or more. It should be accessible everywhere, but in the United States it has never worked that way. Even today, as the overdose crisis continues, you have no chance of getting methadone in most US jails.

In the years since my stints in jail, I’ve been able to move past that life. But there are so many others, right now, still going through the stress and suffering of being denied their medication when they’re locked up. Still coming out, with lowered tolerance and wanting to forget what they’ve just gone through. Still vulnerable to whatever fate the drug supply deals them.

Photograph via Picryl

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I was going through my prescriptions too fast. Then I was introduced to heroin, and fell in love.

Fast forward some years, to 2012. I had pushed my family and friends away to the brink of no return, and I went to detox. I was scared of the pain, of both kinds, that I would experience without the comfort of a needle and drugs.

But they gave me methadone for withdrawal, and right away, I wasn’t in nearly as much pain. Actually, I was more pain-free then I had been since losing my leg. 

After eight days, I left detox and returned home. I was scared again. This time, it was for the embarrassment and shame I would feel for what I’d put my family through; I was also afraid of what kind of life lay ahead. 

I went to my doctor, and we had a conversation because I was back in a great deal of pain and wanting to use. 

I told the doctor about methadone and how well it worked for me, and he said he was comfortable prescribing it as pain management and a deterrence to using heroin. 

I began what at last felt like a normal life. Eight years passed. Then, one day in 2020, I found out my doctor was retiring.

It was the pain management aspect that allowed him to prescribe it to me directly; methadone rules in the United States forbid this if it’s being prescribed for opioid use disorder.

I began what at last felt like a normal life, taking my methadone and not using illicit drugs. Eight years passed.

Then, one day in 2020, I found out my doctor was retiring. 

He told me that nothing would change with my medication. But restrictions and crackdowns during the overdose crisis have left doctors scared to prescribe opioids. I would soon learn just how scared.

The first time I saw my new doctor, he told me straight out that he wasn’t comfortable prescribing me methadone. He suggested that I go to a methadone clinic instead. 

I had heard of these of course, but had never been to one. So I did some research, and found one 15 miles away. I called and did an intake interview. 

I was told I could dose. And that I was going to start at 30 mg. Yeah, 30mg! One quarter of the dose I’d been on long-term. 

I gave them a brief version of my medical history and told them that I was on 120 mg of methadone, and had been for over eight years. I was assured I would be well taken care of. 

I attended my first appointment. Having run out of methadone by that point, I was sicker than I had been in a long time—and wanting to go back to old habits. I pushed those thoughts aside, sucked it up and waited my turn. 

After an exam, I was told I could dose. And that I was going to start at 30 mg. Yeah, 30mg! One quarter of the dose I’d been on long-term. 

At the dosing window, I was told that after two to three days, they would do a dose review and see where I was at. 

The clinic was closed on Sundays, they said, so all patients got one take-home per week. We had to attend in person on the other six days. 

I dose, go home and I am still sick. I’m in severe pain, literally wanting to die.

I went back to the clinic the next day, which was a Saturday, and asked about my dose review. I told them I was very sick and wanted to use. But they said it had to be a minimum of 48 hours before the dose review. So I suffered through it. 

By Monday, I was up at 3 am, counting the milliseconds until 5:30 when the clinic opened. I took hot showers every 30 minutes, to try to get some relief. Finally, I drove to the clinic. 

My review took place, and they told me they would up my dose—by 10 mg. I got just a little relief.

This sequence repeated itself for some time, through multiple further dose reviews, until finally I got to a dose I was ok with.

The clinic hours put my ability to keep my job on a knife-edge. I have to start work 30 minutes after the clinic opens. It’s a 20-mile drive.

Meanwhile, I had to drive to the clinic six days a week, for three months, during the height of COVID, until they had urine-tested me enough to have three “clean” results. Then I was permitted to get two take-homes. This cycle goes on and on.

I got a job offer more recently. But the clinic hours put my ability to keep that job on a knife-edge. I have to start work 30 minutes after the clinic opens. It’s a 20-mile drive from the clinic to work. So as long as I’m waiting at the clinic beforehand and there’s no delay, I can make it, with no room for error. 

The clinic’s missed dose policy, which removes your take-home “privileges,” can really set you back. If I lived further away or didn’t have a car, I’d be in a much worse situation.

It’s bad enough as it is.  At the clinic, counseling is mandatory. One of the first things I was told in rehab years ago is that you can’t force counseling on anyone: You have to want it, otherwise it doesn’t work. 

At the clinic, every patient is a number. You type a number in a computer to check in, and when you’re at the window they ask your clinic number, date of birth and dosage. I’m not sure if they even know my name; they never use it. But facing the threat of being dope sick, you stand up and salute them: “Yes sir,” or “Yes ma’am.” 

I keep returning to this thought: Not so long ago, I was going to my doctor once a month for a prescription and picking it up at a pharmacy. It worked just fine.

Have I seen evidence of SAMHSA’s “relaxed” methadone rules in my clinic? Not so much. 

It took me four years to get to 13 take-homes per month, and I am told how lucky I am. I guess luck is a perception thing; these days, I don’t feel lucky. I’m just hoping maybe one day I won’t have to panic about the time when I go to work. 

When I evaluate my life, and how it’s now dominated by driving back and forth to the clinic and the way they treat me there, I keep returning to this thought: Not so long ago, I was going to my doctor once a month for a prescription and picking it up at a pharmacy. It worked just fine.

One day, I’m hoping that we can get some change and be treated with more dignity. 

Photograph by Helen Redmond

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